Radiology order entry and reporting system

Abstract

A physician in an emergency room inputs a radiology order into a first mobile device. A radiologist receives the order over a second mobile device and inputs a report into the device. The devices provide prompts to input the information according to American College of Radiology guidelines. Information summaries for billing are produced. Physicians who frequently input inappropriate orders can be identified. A learning system uses patient clinical outcomes and pathology results to assess the usefulness of the examinations being performed.

Description

REFERENCE TO RELATED APPLICATION [0001] The present application claims the benefit of Provisional Application No. 60 / 469,411, filed May 12, 2003, whose disclosure is hereby incorporated by reference in its entirety into the present disclosure.FIELD OF THE INVENTION [0002] The present invention is directed to an order entry and reporting system and more particularly to such a system which can be easily, but not exclusively, adapted to the needs of radiologists. DESCRIPTION OF RELATED ART [0003] Despite tremendous advances in imaging technology, there remains confusion as to which imaging examination to order in specific clinical situations, and results of imaging studies (normal and abnormal) are frequently not conveyed to the appropriate healthcare provider. Inappropriately ordered examinations are extimated to constitute 30% of all radiologic studies (1) and are a large hidden cost in healthcare. When patients undergo the “wrong” study for a particular clinical indication their dia...

AI Technical Summary

Benefits of technology

[0015] It is therefore an object of the invention to create an easy to use, mobile, order entry and reporting system with highly accurate flow of information between the emergency department physician ordering the imaging study and the radiologist interpreting the examination. We seek to reduce the improper selection of radiologic examinations, facilitate the rapid performance of urgently needed studies, improve the accuracy of information provided to radiologists to improve their interpretations as well as allowing for appropriate billing, and ensure the timely transfer of significant findings on imaging examinations back to emergency department or local community physicians.

[0031] 1. A mobile platform where a variety of people can enter information in sequence, avoiding redundancy and improving accuracy of information exchange. The portable electronic chart could be transferred from triage people and secretaries entering screening data, to physicians and nurses caring for the patient, who in turn can order radiology studies directly from a mobile electronic chart.

[0032] 2. Software can be developed for all of the interfaces for data entry ensuring it is quick and easy to use to be accepted in a busy emergency department setting.

[0050] 2. Radiology reports would contain information required by billing personnel since this would be entered by the emergency department personnel at the time of the encounter. These reports could be. sent with the bills to insurance carriers reducing the number of bills which are not paid because of missing data.

[0052] 1. Mobile in the ED setting (i.e., personal digital assistant or electronic tablet) resulting in improved efficiency for ED physicians by allowing for ordering examinations at the patient bedside.

[0055] 4. Maximize claim recoveries from third party payers and minimize fraudulent claims by collecting better patient information to be submitted with the bills to these organizations.

Problems solved by technology

Despite tremendous advances in imaging technology, there remains confusion as to which imaging examination to order in specific clinical situations, and results of imaging studies (normal and abnormal) are frequently not conveyed to the appropriate healthcare provider.

Inappropriately ordered examinations are extimated to constitute 30% of all radiologic studies (1) and are a large hidden cost in healthcare.

Additional radiologic imaging increases the cost of care and the possibility of iatrogenic complications from the tests themselves.

The reverse situation of not ordering indicated radiologic examinations could also compromise the quality of healthcare.

If examinations that should be ordered are not ordered, patient diagnoses could be delayed or missed completely.

However there has been no system developed to facilitate or monitor compliance with these guidelines.

The guidelines have been distributed to radiologists nationwide in hard copy and soft copy versions, but most radiologists do not promote their usage and store them in inaccessible locations for use by referring physicians.

Direct verbal consultation between radiologists and referring physicians has also proven unsuccessful in modifying physician radiologic test-ordering practices.

Two inpatient studies conducted at university-affiliated medical centers found consultation between the referring physician and radiologist at rounds or by telephone to be an ineffective method of reducing the rate of inappropriate test-ordering.

Such a system can be affected by non-compliant physicians entering invalid data to avoid what they perceive as unnecessary “additional” steps in ordering examinations or by nonphysicians entering incorrect information due to the same reason or through lacking adequate knowledge about the clinical status of the patients.

However complex imaging studies such as CT and US have intrinsically more information than plain x-rays.

Currently, the standard is for the radiologist to call abnormal reports but human error can lead to significant findings (e.g., incidental lesions, pneumonias, fractures) not being communicated thereby compromising care.

In many hospitals, there is no fail-safe mechanism to ensure that abnormal radiology reports rapidly reach the appropriate healthcare provider.

Delay or inaccurate communication of acute, significant imaging findings can result in serious compromise of patient care.

Nonacute findings, which do not require emergent intervention by ED physicians, are often not reliably communicated to the patient's primary healthcare provider.

The failure to communicate this information can result in suboptimal patient care.

However, it does not overcome all of the above-noted problems.

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